It is difficult
to know how to respond to the sheer idiocy of what nowadays passes for medical
research. Even the most distinguished centres of learning are at it – such as
the investigators at Harvard University who last year offered some further
so-called "insights" into the causes of breast cancer.

Now this, as we all know, is a most grievous illness,
which though more readily treatable than in the past, still blights the lives of
thousands of women every year. It is also, perplexingly, becoming increasingly
more common, especially in younger women, and clearly it would be very useful to
understand why, the better to do something to prevent it.

The Harvard
researchers reported their findings from an investigation into the lifestyle of
120,000 nurses, from which it emerged that those eating on average one egg a day
could reduce their risk of the disease by almost 20 per cent.

They also
found, by some extraordinary coincidence, precisely the same effect
in those eating on average one hot dog every day. This was, however, eclipsed by
broccoli, where apparently every additional serving reduced the risk by a
quarter.

That is the
good news; the bad is that every glass of wine a day increases the risk by six
per cent, although, if correct, a woman would have to knock back 12 drinks a day for 30 years for this to be a serious
threat – by which time no doubt she would already have succumbed to a
combination of brain damage and liver failure.

These findings
cannot possibly be true and, indeed, the insouciance with which the Harvard
researchers report them suggests that they think so too. It would, after all, be
very important indeed if alcohol really did increase the risk of breast cancer,
and a daily diet of eggs, hot dogs and broccoli reduced it.

This parody of
science has been a familiar lament in this column over the years but now, thanks
to John Brignell, a former professor of industrial instrumentation, we know why.
Prof Brignell has, as his field of expertise would suggest, always been
concerned with the value of precise measurement, on whose integrity and accuracy
so much of human society depends. If we don't get the measurements right,
buildings will fall down and machinery grind to a halt.

There are clear
parallels here with medicine, where accuracy is equally important, but when Prof
Brignell came to investigate the research examining the links between lifestyle
and disease,

he discovered
such "systematic lying on a grand scale", such a "complete
travesty of the truth", that he decided to write a book about it.

It is, he
points out, intrinsic to the human condition to want to understand why things
happen: why the sun rises and sets, why the tides ebb and flow and why one
person gets a particular illness and another doesn't.

The problem of
course is that "causes" in nature are invariably concealed from view
and it is necessary to find some way of making them apparent. Hence the enormous
success of the microscope in the 19th century, allowing scientists to visualise
for the first time the minuscule bacteria that cause infectious diseases.

The modem-day
equivalent is the search for the causes of illness in the infinite complexity of
people's lives by comparing those with and without some condition and then
inferring that any obvious difference must be a contributory factor. This
clearly works when comparing the disease profile of smokers with non-smokers,
but when "the cause" is due to some unknown biological agent, such
studies will be unable to identify it and, instead, wrongly infer that some
aspect of lifestyle is responsible.

The interest of
Prof Brignell's book is his lucid exposition of the many ways the researchers,
deliberately or otherwise, fail to distinguish truth from mere conjecture,
providing the never-ending stream of health scares with which we are by now so
familiar.

This type of
scientific research not only trivialises a serious matter but also manages to
obscure what is known about the causes of breast cancer and what can or cannot
be done about it.

Thus the rise
in incidence in recent years is clearly related to changing patterns of
reproduction, and the effect that this might have on the exposure of the tissue
of the breast to female hormones. There seems no doubt that those who delay
having children until their thirties and then breastfeed them for just a few
weeks have a moderately increased risk of the disease. But this is not
necessarily something that one can do much about.

It is scarcely
realistic to suggest that all women should have their first baby early, before
the age of 20, produce lots of them and breastfeed them all for several months.
So, instead, medical researchers advise that they should avoid alcohol and eat
more eggs and hot dogs. Quackery rules OK.

Some years
ago I discovered a website, Number Watch, maintained by a Professor Emeritus of
Industrial Instrumentation who resides in England. It was and is devoted to
debunking the many scare campaigns that assail and afflict us daily via idiotic
headlines in newspapers and other stories broadcast on radio and television.
John Brignell, like myself, was so incensed by these deliberate lies, many of
which have caused the needless deaths of millions, that he has devoted himself
to attacking them.

When his
book, Sorry, Wrong Number, was published a few years ago, I was
pleased to enthusiastically endorse it for the way he demonstrated the
distortion of statistics to advance bad and false "scientific" claims.
He has recently published The Epidemiologists: Have They Got Scares for
You! The best and easiest way to purchase one or both is to visit www.numberwatch.co.uk.
Suffice it to say they both have garnered great reviews.

I have come
to know Prof. Brignell via his lively, witty, monthly commentaries on his
website, through his books, and the occasional exchange of emails. In his most
recent book, he initially guides the reader through to an understanding of how
"scientific" data can and is routinely distorted or simply invented
out of thin air to achieve short-term fame or long-range campaigns to ban
anything or force lifestyle changes on people by getting politicians to write
bad laws based on bad "science."

"After
a couple of centuries in which science, representing the triumph of reason, had
revolutionized human life and tripled life-span, it was now reduced to the
status of necromancy or astrology", writes Prof. Brignell in his new book.
"As I researched the subject I began to discover a systematic lying on a
grand scale, reaching into the upper strata of our society."

One branch
of science, in particular, receives the attention of his new book. Epidemiology
began as an effort to determine the real causes of epidemics that took hundreds
and thousands of lives. In our modern era, many are unaware of the effect on
history that disease has had. From the Bubonic plague to Malaria, Smallpox,
Influenza, Typhus ad Typhoid, Cholera and Tuberculosis, among others, disease
has decimated vast populations and still has the capacity to do so. The recent
outbreak of SARS in China sent shock waves of fear through the entire world.

At a time
when neither physicians, nor the public had any idea of what germs were or how
rapidly they multiplied given the right circumstances, people believed such
epidemics were the result of "bad air" poisoned by the emissions from
swamps or other sources. Indeed, Malaria comes from the Italian translation for
bad air. Sanitation in large cities and small was virtually non-existent.

Not until
the scientific methods were developed to identify the true sources of disease,
along with the development of the statistical testing of scientific hypotheses,
were these diseases identified and the means found to avoid their spread. This
took several centuries, beginning seriously in the 1700s with the rise of the
Age of Reason.

Today,
however, the media spread the contagion of "junk" science based on the
most worthless claims made, as often as not, in formerly respected science
journals. Often, the claims are nothing more than a public relations
"news" release by some institution that wants to gain attention for
its "researchers" and "scientists." Time and again, when
such claims are found to be baseless, that news goes unreported.

Throughout
his new book, Prof. Brignell repeats, "Correlation is not causation."
It is the one lesson he wants to reader to retain because all junk science
claims are replete with the words, "might", "may" and
"could." Something might cause cancer. Something may trigger heart
disease. Something you eat could make you fat. Over and above all these claims
is the most obvious condition of mankind. As one gets older, they become more
likely to become ill from some cause.

The
corruption of science is vast. As Albert Einstein once pointed out, "Only
two things are infinite, the universe and human stupidity, and I’m not sure
about the former."

Stupidity or
just plain old ignorance contributes greatly to these "modern times"
in which millions of people succumb daily to the latest or most on-going scare
generated by environmentalists and, in the case of Prof. Brignell’s new book,
scares by epidemiologists concerning diet, i.e., food and drink of every
description, campaigns waged against the proper use of pesticides, chemicals
that attack disease-spreading insects and rodents, or herbicides, chemicals that
attack weeds that reduce the capacity for farming large quantities of wheat,
rice, corn and all the other food products available through modern agriculture.

Then there
are the lies about radon, chlorine, salt, and even vitamin supplements, to name
just a few of the campaigns cited in The Epidemiologists.

Behind all
this scare mongering is the quest for power and profit. The many organizations
that have proliferated to control our lives, our choices, our freedom to enjoy
anything and everything that tastes or feels good, exist for both the
gratification of exercising power and, in many cases, for the millions of
dollars that can flow to such organizations through donations, sales, and
government grants.

Learn how to
spot fallacious logical arguments. Develop your capacity for critical reading,
and discover how emancipating it is to free yourself of the endless stream of
lies that passes for science in the public interest these days.

Referring to
one such study, Prof. Brignell calls it "a festival of numerical
prestidigitation."

It is this
combination of rock solid knowledge, a raging skepticism, and a talent for the
felicitous phrase that makes his latest (and previous) book so worth reading.

Fifty years ago, we discovered that smoking
is bad for us. In 1954, Austin Bradford Hill and Richard Doll
published a preliminary report on a study showing the very
strong correlation between smoking and premature mortality (1).

However, this classic study has in many ways
sent medical science up a blind alley. While the dangers of
smoking have been demonstrated in numerous subsequent studies,
the attempts to find the New Smoking - another example of an
environmental or lifestyle factor that causes substantial health
problems - have largely failed. But the many pieces of junk
science that have been produced in the process have provided the
ammunition for unwarranted health scares too numerous to
mention.

This state of affairs is well described in John
Brignell's new book The
Epidemiologists. Hill and Doll were given the task of trying
to find out why cases of lung cancer had increased 15-fold in
only 25 years. Their first attempt was to ask 649 lung cancer
patients, and 649 matched controls, about their habits. What
they found was a correlation between smoking and lung cancer,
albeit not a very strong one. However, it was strong enough to
warrant a fuller study, starting with a large group of healthy
individuals, assessing their smoking habits and then monitoring
them to see what diseases they developed.

This study began in 1951. Their method was to
write to every doctor in the country - around 35,000 doctors
replied, of whom only 17 per cent were lifelong non-smokers (how
times change). The doctors were asked just a few questions about
their smoking habits. Three years later, Hill and Doll published
their first analysis of the results, and were already able to
indicate how strong the link was between smoking and lung
cancer.

What they found was that persistent smokers were
24 times more likely to develop lung cancer than non-smokers.
Moreover, the risk of death from heart disease in any particular
year was roughly doubled. This study has been followed up every
few years, and these results have been confirmed time and again.

Hill made it clear, however, that such a study
had to comply with some pretty strict criteria in order to be
considered valid. These criteria are worth restating, because
they stand in sharp contrast to the bulk of epidemiological
research:

Strength
Is the association strong enough that we can rule out other
factors?

Consistency
Have the results been replicated by different researchers,
and under different conditions?

Specificity
Is the exposure associated with a very specific disease as
opposed to a wide range of diseases?

Plausibility
Is there a credible scientific mechanism that can explain
the association?

Coherence
Is the association consistent with the natural history of
the disease?

Experimental evidence
Does a physical intervention show results consistent with
the association?

Analogy
Is there a similar result to which we can draw a
relationship?

Above all, as Brignell emphasises, correlation does not prove
causation. He draws an analogy with growing tomatoes and
fertiliser. It can easily be shown that increasing use of
fertiliser will increase tomato yields. But fertiliser does not
cause tomatoes, it merely promotes the process of growth. The
same goes for smoking and lung cancer. Smoking may massively
promote the growth of lung cancer, but from this we cannot
conclude that smoking causes the tumours. We can only draw
conclusions about causation if we actually investigate the
mechanisms that lie behind the link between smoking and lung
cancer. Hill and Doll had nothing to say about why cancer
occurs, they just provided us with a very valuable lead in the
investigation.

Nonetheless, it is an entirely reasonable
conclusion to draw that smokers will, on average, die younger
than non-smokers, and we do not need to know the precise
mechanism to conclude that giving up smoking is prudent from a
health viewpoint.

What is not reasonable is the response to this
one, classic study. First, it has provided the justification for
state intervention in lifestyle in a previously unprecedented
way. Secondly, it has encouraged the proliferation of other
studies, which make grand statements about disease based on
correlations far weaker than those found by Hill and Doll.

Brignell's book is a handy demolition of the
science and statistics behind this epidemic of epidemiology. He
shows how statistical tests were originally developed, based on
certain assumptions. However, these assumptions have long since
been forgotten, so that meeting certain abstract criteria has
been elevated above whether the results are actually of any
real-world importance.

The most important of these is the test for
statistical significance. The idea behind this is that patterns
can be found in any set of random results. For example, in the spiked
office, there are a number of people who were born in May or
June, but none were born in July. It would be possible to draw
the conclusion that there is something special about being born
in May or June that predisposes people to become journalists.
This would be a bizarre conclusion to draw from just a handful
of people. In fact, the spread of birthdays is completely
coincidental.

In research it is therefore useful to have a
preliminary statistical test of results, to see how likely it is
that they could be due to blind chance. The usual benchmark is
that if the chances of a set of results being coincidental are
less than five per cent, it is reasonable to go on to assess
whether the results are actually meaningful.

First, just because a study passes this test
does not mean its results aren't a complete coincidence. In
fact, by definition, five per cent of studies could pass this
test even though the results are meaningless.

Secondly, just because the results are
statistically significant doesn't mean they are practically
significant. Brignell gives the example of a book called The
Causes of Cancer, written by Richard Doll and Richard Peto.
Illustrating Doll's fall from previous high standards, the book
describes some deaths of people in their 80s and 90s as
'premature'.

The public health agenda is
justified by research that is often completely worthless

These days, however, it seems that any result
that passes this 'p-test' is increasingly regarded as
significant. Five per cent sounds like a low risk of results
being meaningless, until you realise that researchers often
plough through many, many potential risk factors (what Brignell
calls a 'data dredge'), look for an apparently significant
result, then try to speculate some kind of mechanism to explain
it, no matter how bizarre. So a test designed as an initial
filter to weed out spurious results is used to give credence to
them.

Thus he provides a huge list of different
factors that have, at one time or other, been accused of causing
cancer: abortion, acetaldehyde, acrylamide, acrylontiril, agent
orange, alar, alcohol, air pollution, aldrin, alfatoxin,
arsenic, asbestos, asphalt fumes, atrazine, AZT…and that's
just the letter 'A'.

There are also a number of techniques in
epidemiology for imposing assumptions on to data. The best of
these is trend fitting. No set of data will exactly fit a
pattern but often a clear trend can be found nonetheless.
However, many studies appear to resort to drawing a line through
an apparently unconnected series of measurements to demonstrate
an underlying effect.

Epidemiology can be an effective tool when
applied to the spread of infectious disease. Unfortunately,
there really isn't anything like enough infectious disease in
the developed world to justify the existence of so many
departments and researchers. In fact, the overwhelming cause of
death in the developed world is old age - a factor that is,
incredibly, frequently ignored by researchers. A person in their
eighties is a thousand times more likely to develop cancer than
someone in their thirties. This factor is so powerful that for
most of the causes of disease studied, a very minor
underestimation of the effect of age can wipe out any putative
effect from the factor in hand.

Age is obvious - but many other confounding
factors are not. Therefore, we return to Hill's first criterion:
to be sure there is actually something going on, the effect must
be strong. Otherwise, any apparent effect may prove to be
entirely illusory.

A topical example of this is passive smoking,
and in particular what Brignell calls 'the greatest scientific
fraud ever'. In 1992, the US Environmental Protection Agency
published a meta-study, bringing together many other studies on
passive smoking. Unfortunately, the results were negative. It
appeared that passive smoking was not a health risk at all. Mere
facts could not be allowed to get in the way of a health scare,
so some imagination was applied to the problem. One negative
study was removed - but the meta-study still produced no
statistically significant result.

So the goalposts were not so much moved as
widened. The organisation found that there was a greater than
five per cent chance that the results were coincidental, but
less than 10 per cent - so they accepted them anyway. In other
words, the EPA accepted a bigger risk that the effect they found
was purely due to chance, quite at odds with standard practice.

The increased risk of lung cancer they found -
19 per cent - was frankly too small to have been conceivably
detected given the methods they used. There are lots of ways in
which inaccuracy could have crept into this final result. For
example, is it really possible to merge the results of many
different studies, all with different methodologies and
subjects, accurately? How could someone's actual exposure to
environmental smoke be measured over the course of years? Were
all the people who said that they were non-smokers absolutely
honest? As indicated above, were other possible contributory
factors such as age, gender and income controlled for
accurately?

We can be pretty confident about Hill and Doll's
conclusions about lung cancer because the effect they found is
massive - an increased risk of 2400 percent. To suggest that
such a small effect as 19 per cent could be accurately measured
in this way is like trying to time a race with a sundial.

That has not prevented smoking being banned in
public places on the grounds that thousands of people might die
from inhaling second-hand smoke. The public health agenda is
therefore driven and justified by research that is more often
than not completely worthless.

It is undoubtedly the case that Hill and Doll's
study has caused people to give up smoking and extended many
lives as a result. But it has also inspired a heap of
unnecessary panics based on dodgy research, and public health
campaigners only too willing to tell us how to live our lives.

IntroductionReview of a scarey book about quacks, charlatans and
junk-science.

The epidemiologists – Have they got the scares
for you! By John Brignell, Brignell and Associates, Great Britain, 2004.

Hot of the press, this latest book by John Brignell outing the
charlatans amongst us is most disturbing. Disturbing because what I, and I
suppose most of us, read in the newspapers and assume to be accurate, is
anything but - the amount of rank bull dust masquerading as scientific
fact published by the media is astonishing.

John Brignell retired early from his Professorship of Industrial
Instrumentation at the University of Southampton to write about the abuses
of measurement – leading to his first book – Sorry – wrong
number! Published in 2000. Since then he has set up his website
“www.numberwatch.co.uk” where hapless individuals and organisations
are roundly castigated for various numerical crimes. I inadvertently
scored a hit there too – which arose from a misunderstanding of how we
in the mining industry compute statistics – but it did lead to a very
succinct analysis of global warming statistics and another demonstration
that global warming is a sham.

But back to this book – as the title suggests, it has something to do
with epidemics and hence the medical profession and the health-care
industry. The book starts off with a good start by repeating two newspaper
headlines in the UK – The Independent , June 5 2001 - “Pets
double children's risk of asthma attacks” and the from the BBC
a few days earlier “Keeping pets prevents allergies”.

Assuming that the both The Independent and the BBC
got their information from the same source, how could such contradictory
statements be published? Or how about “Pain killers prevent cancer”,
yet at another time “Regular pain killer use linked to cancer”.
Clearly the newspapers are obviously quoting scientific studies, perhaps
it was because scientists were contradicting each other, or is it.

Damning as it is, Brignell sums it up nicely by writing that
“science, ..had revolutionised human life and tripled life-span, ..was
now reduced to the status of necromancy or astrology. Brignell's
expertise was in avionic instrumentation and from what one reads, it was
the published baloney in his daily morning newspaper which prompted his
first opus - “Sorry, wrong number”. Having finished that area of
science, he then discovers another branch of science that also seemed to
have degenerated into a corrupt travesty – epidemiology – the science
of epidemics.

What concerned him more than anything was how the very people who
sought to introduce scientific rigour into the science of epidemiology
inadvertently provided the means of its corruption. In order to do
that, of course, one needs to go back into history and discover how it all
began, and when and why it started to go wrong, and who the villains were.
Epidemiologists are not always the bad guy, it seems, and to find that
out, you will of course have to buy the book.

The early chapters deal with the early history of epidemiology, the
terrible epidemics which plagued humanity. Then follows the discovery of
what actually caused disease, and importantly a summary of one of the
pioneers of statistics, and the irony of his legacy. The came Social
Theory – which turned scientific medicine upside down and changed the
world.

The second half of the book deals with the overwhelming amount of
material available to us on almost every imaginable topic of medicine. Of
course the author also shows how the present situation came about, looking
at the tools of the trade and the fallacies. And of course nothing like
picking the bones of a few pertinent examples.

Inside the cover, or at least on page ii of the flyleaf we find a Time
Chart of disease – starting from 2000 BC to today, and covering
everything in between. How, one would think, could all this be covered in
such a slim volume of some 200 pages? Well fortunately Brignell doesn't,
but he does focus on the essentials and some pertinent real case
histories.

Most importantly he does spend some time on Social Theory – and don't
make the mistake I made by looking up a dictionary – my Chambers does
not have an entry for it, and googling on the Internet doesn't yield
anything precise either. And that is precisely the problem – what on
earth is Social Theory? Having suffered the requirement myself in my
undergraduate days to do one or two “humanities” subjects, I guess
Social Theory had to have its origins in that part of Academia, and as
Brignell puts it “The study of kings and queens had been largely
replaced by the study of the masses, Social History,..”. Just this
little instance of the difficulty to get a precise meaning of Social
Theory starts to explain what has happened over time.

Brignell points to one individual Thomas McKeown who wrote two
influential books, “The role of Medicine” and "The
Origins of Human Disease”. It seems that McKeown accidentally
became Professor of Social Medicine, as the result of some funding of a
Trust which wanted a specific chair of Social Medicine. The best way
of showing what then happened was the disease of Tuberculosis (TB) –
which if I read Brignell right, was regarded by McKeown as a disease of
poverty, being one of infectious type, while those of affluence were
non-infectious diseases. Personally this categorisation of disease is a
load of nonsense, which Brignell then expertly shows to be so in the rest
of his chapter on Social Science. (Social Theory can be thought of
as one of the most influential philosophical developments in human history
bequeathing us the Nanny State and the environmental quangos).

Usually diseases are caused by something, and Brignell rightly uses the
furphy of cigarette smoking causing lung-cancer as his next demolition
job. My late father, a physician and surgeon, always maintained that
individuals who developed cancer of the lung, also tended smoke
cigarettes, and that the cigarette smoking was a symptom, and not the
cause of lung-cancer.

Other chapters discuss statistics, in a highly readable form, then a
brief description of the tools of the trade, essential knowledge to
unravel the pronouncements of science published in the mass-media,
while the chapters Body parts, Substance Abuse, Tobacco Road, and Cancer
are pretty obvious what they deal with.

The Chapter Holocaust was another matter – and what, I
thought, has this well known WWII event to do with the subject of his book
– and of course it wasn't what you think it was, it was actually Foot
and Mouth Disease in the UK and how the Brits managed to completely
stuff it up – veritably a holocaust of the intelligence type. They
and they alone, with their stupid scientific advisors decided to cull all
the culprits, with the equally culpable epitome of bureaucracies, the
European Commission.

A rather interesting observation was made on page 96 when the author
discusses SIP's Single-Issue-Parties where groups of fanatics form
political parties. This is usually a non event except in societies in
which proportional representation operates, and then indeed we are
politically affected by these minority fanatics. The Greens, for
example, managed to gain a virtual monopoly of the environment ministries
of Europe and forced environmentalism onto those hapless Europeans.
As the Ice age doom theory literally froze in the middle 1960's, the
Greens then reversed direction and starting screaming the opposite –
global warming.

“The ease with which a specious theory such as global warming can be
imposed on the world constitutes a textbook example of political
chicanery”. And once a theory reaches a critical mass of acceptance, no
matter how stupid or scientifically specious, it becomes established fact.

The rest of John Brignell writes about means you have to buy the book
from his website but I can assure it was a riveting read – I finished it
in two nights in bed.

This book is a welcome relief for the usual pseudo-science we are
deluged with in the media. It is an excellent source of fact, and lists
and explains important concepts so that anyone can separate the wheat from
the chaff in their daily newspaper.

All in all a significant contribution to the demolition of quacks,
charlatans and junk-science.

John Brignell has devoted his life to the art of measurement in
science and engineering, teaching initially at the City University of London and
later the University of Southampton where, for twenty years, he was Professor of
Industrial Instrumentation. He has a raft of awards and fellowships, but what
caught my attention was his dedication to debunking the many environmental,
food, energy, and other hoaxes intended to influence our lives through
legislation and other mandates. His website, www.numberwatch.co.uk
is an opportunity to discover that Great Britain is as much awash in mindless
regulations and failed government programs as our own. His first book, Sorry,
Wrong Number, reflects how this affects both Brits and Yanks. I was
delighted to recommend it when it was published and am now twice as pleased to
recommend The Epidemiologists: Have They Got Scares for You! ($29.00).
Published in the UK, you can purchase a copy by contacting Prof. Emeritus
Brignell via his website. His new book educates the reader to a better
understanding of how science is frequently deliberately corrupted and then used
to frighten people into believing that everything they eat, drink and breathe is
going to kill them. Thus, initially, the reader gets a crash course in some
fundamental scientific concepts. Thereafter, he demonstrates how the public is
led astray by weasel words and twisted data. This is an extraordinarily
entertaining book!